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Biomedical subjects

J Hughes

Publications and source records attributed to J Hughes.

At least 253 records · Page 14Linked to original sources
PubMed1996

The effect of Edmonston-Zagreb and Schwarz measles vaccines on immune response in infants.

The effects of measles immunization on immune responses in infants and the roles of vaccine strain and age of immunization are not known. Eighty-eight children were immunized at 6 or 9 months of age with the Edmonston-Zagreb (EZ) or Schwarz (SW6, SW9) strain of measles vaccine. Children were studied before and 2 weeks and 3 months after immunization. Seroconversion was similar, but geometric mean neutralizing titers at 3 months differed by vaccine group: SW9, 1367 mIU/mL; SW6, 982; and EZ, 303 (P = .003). Mitogen-induced lymphoproliferation was decreased at 2 weeks in the SW9 group and at 3 months in all groups and was negatively correlated with measles antibody level at 3 months (r = -.387, P = .003). CD8 T cells, soluble CD8, neopterin, and beta2-microglobulin were increased at 2 weeks in the SW9 group, and soluble CD8 and beta2-microglobulin remained elevated at 3 months. Therefore, measles immunization resulted in suppression of lymphoproliferation, which was most evident in infants with the highest antibody responses and most immune activation.

Age Factors↗
PubMed1996

Reassessing medical students' willingness to treat HIV-infected patients.

BACKGROUND: Past research has demonstrated that some physicians do not feel obligated to care for patients infected with the human immunodeficiency virus (HIV). This study sought to characterize the attitudes that affect medical students' willingness to treat HIV-infected patients and to determine which attitudes are most amenable to intervention. METHOD: All 414 matriculating medical students at three Chicago schools were surveyed in 1994. After reliability-testing the attitudinal scales, the authors created a predictive model by using multiple regression analysis. RESULTS: A total of 297 (72%) of the matriculating students responded. Ninety-two percent of the students agreed that patients with HIV would be welcome in their medical practices. As in past studies, a strong sense of professional obligation was associated with willingness to treat, and fear of infection and homophobia were associated with decreased willingness to treat. The authors' measure of concern about social stigma was also associated with decreased willingness. Together, these factors accounted for 53% of the variance in the Willingness to Treat scale. CONCLUSION: In addition to confirming the predictors found in previous studies, this study demonstrated that perceived social stigma is a measurable predictor of decreased willingness to treat (with the understanding that willingness to treat is influenced by both personal and social factors). A comprehensive approach, not only in curriculum design but also in admission and policy, might better prepare students to treat HIV-infected patients.

Acquired Immunodeficiency Syndrome↗
PubMed1996

What role does apoptosis play in progression of renal disease?

Apoptosis (programmed cell death) is now recognized to play an important role in regulating the number of renal cells in health and disease. Apoptosis may mediate beneficial deletion both of leukocytes and of excess resident cells from the inflamed glomerulus. However, this review focuses on the growing evidence that inappropriate engagement of the cell death 'program' contributes to the progression of renal diseases such as polycystic kidney disease and glomerulonephritis, mediating the loss of 'desirable' cells and eventual development of the hypocellular end-stage kidney.

Animals↗
PubMed1996

Cardiovascular findings in self-reported healthy elderly. The Elite Seniors Study.

BACKGROUND: A descriptive study of self-reported healthy elderly in Newcastle was undertaken for an adequate understanding of the normal characteristics of the elderly. AIMS: We sought to determine the frequency of abnormal clinical, laboratory and echocardiographic findings in a self-reported healthy elderly population. METHODS: Volunteers aged greater than 75 years were recruited from active members of the region's bowling clubs. Forty-five subjects with no self-reported vascular or cardiac disease underwent clinical, laboratory and echocardiography assessment. RESULTS: Minor cardiovascular abnormalities were frequently detected. Echocardiography correspondingly found a high frequency of haemodynamically insignificant degenerative valvular lesions. Doppler left ventricular filling pattern of abnormal relaxation was a universal finding. CONCLUSION: There is a high prevalence of age-related echo-Doppler abnormalities in the self-reported healthy elderly with important implications for the interpretation of echo-Doppler studies.

Aged↗
PubMed1996

The costs of treating miscarriage: a comparison of medical and surgical management.

OBJECTIVES: To estimate and compare the costs of surgical and medical treatment of miscarriage to the National Health Service. DESIGN: A patient-centred, partially randomised trial. SETTING: A teaching hospital in Scotland. PARTICIPANTS: Four hundred and thirty-seven women with a proven first trimester miscarriage. MAIN OUTCOME MEASURES: The cost per patient of surgical and medical management of miscarriage plus the extra cost per patient of introducing medical management of miscarriage under three different scenarios are calculated. RESULTS: The average cost of surgical treatment was Pounds 397 compared with Pounds 347 for medical treatment. Sensitivity analysis showed that the extra cost of introducing the medical management of miscarriage ranged from a cost saving of Pounds 71 per patient to an additional cost of Pounds 47 per patient. CONCLUSIONS: Our analysis showed that it may be possible to generate cost savings by introducing medical methods in the management of early miscarriage. However, the savings assume that costs associated with theatre use can be fully realised.

Abortion, Induced↗
PubMed1996

Steady-state plasma concentrations of midazolam in critically ill infants and children.

OBJECTIVE: To determine the steady-state plasma concentrations of midazolam in critically ill infants and children. DESIGN: Prospective uncontrolled study conducted over 18 months. SETTING: Regional pediatric intensive care unit in a children's hospital. PATIENTS: Thirty-eight infants and children, aged 1 month to 13 years, requiring midazolam as sedation during mechanical ventilation. The patients were divided into three age groups: (1) infants less than 12 months (n = 16); (2) children 1-2 years (n = 12); and (3) children aged 3 years and older (n = 10). MAIN OUTCOME MEASURES: A single blood sample was collected once steady-state plasma concentrations of midazolam were achieved during a continuous intravenous infusion. Plasma clearance was calculated from the plasma concentrations and infusion rate. RESULTS: The plasma clearance was higher in children aged 3 years and older (median plasma clearance 13.0 mL/min/kg) than in infants and children 1-2 years old (median plasma clearance 3.1 and 2.3 mL/min/kg, respectively) (Kruskal-Wallis analysis of variance, p < 0.01). The midazolam infusion rates were similar for the three groups studied (Kruskal-Wallis analysis of variance, p > 0.05). The plasma concentrations of midazolam were significantly lower in children 3 years and older (median plasma concentration 128 ng/mL) than in infants and children 1-2 years old (median plasma concentrations 395 and 790 ng/mL, respectively) (Kruskal-Wallis analysis of variance, p < 0.05). CONCLUSIONS: The plasma clearance in children 3 years and older was higher than in infants and children up to 2 years old. There was considerable interindividual variation in the steady-state plasma concentrations of midazolam in critically ill infants and children.

Adolescent↗
PubMed1996

Analysis of capsular tissue from patients undergoing primary and revision total hip arthroplasty.

Late aseptic loosening of revision total hip replacements is a common cause of failure. At revision surgery, a foreign pseudo capsule membrane surrounding the implant develops. These tissues are thought to reflect a response due in part to an increase in particulate debris, generated by normal wear of the bearing surfaces. The foreign body membrane consists of macrophages and giant cells lying in between the bone and the implant. The cell types identified at the interface included lymphocytes, histiocytes, macrophages, and giant cells, and their contribution to implant loosening due to bone resorption is the focus of this investigation. Capsular tissues surrounding failed joint arthroplasties were characteristically different by gross morphological observations. The capsular tissue contained a region of tissue approximately 4-6 cell layers in depth lining the capsule, which resembled synovial like cells. This region of the capsular tissue consisted of loosely organized fibrous tissue containing numerous histiocytes and foreign body giant cells demonstrated by hematoxylin and eosin. Immunological staining of the capsular tissue for IL-1 activity showed the reactivity to be localized directly adjacent to the implant in well vascularized areas. Tissue farthest from the implant were less reactive and resembled tissue extracted from primary patients. Quantitative ELISA data for IL-1 activity from these areas reflect the observations observed by immunostaining.

Enzyme-Linked Immunosorbent Assay↗
PubMed1996

Evaluation of the biomaterial-interface of screw threads in patients having clinical pain.

Fixation devices are normally anchored and stabilized with the use of metallic screws. Under normal circumstances, the patient has no adverse response to the fixation device. However, there are some patients that experience a significant amount of pain and the hardware needs to removed. Removal of the hardware, alleviates the pain. The tissues adjacent to the implanted devices were harvested and analyzed histochemically for cellular detail and immunochemically for the presence of PGE2. These tissues were compared with tissues retrieved from nonpainful stable fixation devices that were removed when they no longer were needed for stabilization. The results showed radiographically the presence of osteolysis in the area of the screw thread in patients with clinical pain. Also, histologically there was a presence of synovial-like granuloma tissue possibly produced by the micromotion of the loosened screw. When the tissues were analysed qualitatively by ELISA for PGE2 they had a statistically significant amount in comparison with tissue retrieved from patients with no clinical pain. The presence of PGE2 in the tissues suggest that this inflammatory mediator is produced in tissues adjacent to unstable devices and may mediate the osteolysis associated with the late implant failure and clinical pain.

Biocompatible Materials↗
PubMed1995

A study of patients' experiences of side-effects associated with chemotherapy: pilot stage report.

This paper reports findings from the pilot stage of a longitudinal descriptive study of problems experienced by day-patients undergoing chemotherapy treatment with the Day Ward, Worthing Hospital. Unlike the majority of studies in this field, this study allows documentation of all side-effects perceived by the patient as important, and is designed to follow the progress in incidence and severity of each problem through the treatment course. Preliminary findings show some 100 side-effects have been identified, with different problems being most troublesome for each treatment regime. Full data are provided. The study emphasises the importance of regime-specific data both in formulating clinical practice and in the provision of patient education.

Adaptation, Psychological↗
PubMed1995

c-fos antisense oligodeoxynucleotide increases formalin-induced nociception and regulates preprodynorphin expression.

Rats, receiving an intrathecal pretreatment of oligodeoxynucleotide complementary to c-fos mRNA (antisense), showed no increases in Fos protein or preprodynorphin messenger RNA in the outer laminae of the lumbar spinal cord when challenged 4 h later with a 50 microliters intraplantar injection of 5% formalin. Animals pretreated with saline or sense oligodeoxynucleotide showed marked increases in Fos protein (2 h after formalin challenge) and preprodynorphin mRNA (20 h after formalin challenge) in the lumbar region of the cord ipsilateral to the side of the injection. The behavioural consequences of antisense pretreatment were an increase in the formalin-induced licking/biting responses during the tonic, but not the acute phase. These observations could be interpreted as representing a sequence of events beginning with the formalin-induced increase in the transcription factor Fos, which in turn increases the synthesis of preprodynorphin messenger RNA resulting in the production of the dynorphin opioid peptides which then exert a modulatory antinociceptive action.

Animals↗
PubMed1995

Changes in hypothalamic cholecystokininA and cholecystokininB receptor subtypes and associated neuropeptide expression in response to salt-stress in the rat and mouse.

This study demonstrates cholecystokinin receptor plasticity in response to salt-loading in the rat and mouse hypothalamus. It identifies, for the first time, the cholecystokinin receptor subtypes involved, firstly by receptor autoradiography and secondly by in situ hybridization. Both species showed increases in hypothalamic [125I]Bolton Hunter-cholecystokinin-8 binding. Co-incubation with the specific cholecystokininA and cholecystokininB antagonists, devazepide and CI-988, indicated that in the rat cholecystokininB receptor binding markedly increased, with a small increase in cholecystokininA receptor binding. In the mouse the response was comprised solely of cholecystokininA receptors. In situ hybridization studies were carried out on a range of peptide messenger ribonucleic acids after salt-loading. In the rat large increases in hypothalamic gene expression were detected for oxytocin, vasopressin, corticotrophin-releasing factor and preprocholecystokinin. In the mouse only vasopressin messenger ribonucleic acid increased, whilst hypothalamic oxytocin, preprocholecystokinin and corticotropin-releasing factor remained unchanged. However, corticotrophin-releasing factor messenger ribonucleic acid increased in the mouse amygdala. In situ hybridization was performed using oligonucleotide probes specific for either the cholecystokininA or cholecystokininB receptor messenger ribonucleic acid, and this showed good agreement with the receptor autoradiography. CholecystokininB receptor expression was upregulated in the rat hypothalamus along with a small but significant increase in cholecystokininA receptors. In the mouse only cholecystokininA receptor expression was increased. In addition to these molecular changes rats lost about 25% of their body weight during six days of salt-challenge, whilst mice continued to grow in line with controls. This work demonstrates differential changes in cholecystokinin receptor subtype binding between the rat and the mouse. It represents the first report of differential changes in cholecystokininA and cholecystokininB receptor messenger ribonucleic acids within the brain, and shows that cholecystokinin receptors within the rodent hypothalamus are capable of plastic responses to chronic osmotic stress.

Animals↗